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Blood coagulation Flashcards

(51 cards)

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1
Q

describe the blood clotting process

A
  1. severed or injured blood vessel contract, restrict blood flow
  2. platelets aggregate form hemostatic plug
  3. activation of platelets initiates clotting cascade (fibrin appears)
  4. fibrin clot forms (secondary hemostatic plug)
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2
Q

what causes platelet activation?

A

circulating platelet binds to subendothelial collagen and vWF exposed during injury

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3
Q

T/F platelets do not have a structural change during activation

A

false

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4
Q

What recruits more platelet activation?

A

TxA2 and ADP

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5
Q

aspirin

A

inhibit platelet activation

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6
Q

thrombocyte

A

platelet

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7
Q

thrombocytopenia

A

lack of platelets

more bleeding

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8
Q

thrombocytosis

A

too many platelets

blockage of blood vessels

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9
Q

Draw the coagulation cascade

A

Coagulation PPT Slide 6

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10
Q

What are some coagulation factors?

A

phospholipids, Calcium and Gla proteins

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11
Q

Where are coagluation factors produced?

A

liver, released as zymogens

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12
Q

What do Gla proteins depend on?

A

Vitamin K

due to vitamin K dependent carboxylase

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13
Q

platelet count

A

measures # of platelets in serum

routine in CBC

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14
Q

what is a normal platelet count?

A

150,000-400,000 cells/microL

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15
Q

prothrombin time (PT)

A

rate of clotting by extrinsic and common pathways (usually amount of prothrombin in plasma)

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16
Q

what is normal PT?

A

10-14 seconds

normal INR 1.1

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17
Q

What medication usage should you always order a PT for?

A

warfarin

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18
Q

partial thromboplastin time (PTT)

A

rate of clotting time by intrinsic and common pathways

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19
Q

What is normal PTT?

A

30-42 seconds

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20
Q

activated clotting time

A

bedside test of entire clotting process

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21
Q

hemophilia A

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A

factor VIII deficiency

22
Q

afibrinogenemia

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A

lack of fibrinogen

23
Q

vonWillebrand Disease (vWF deficiency)

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A

missing or defective vWF

24
Q

vWF

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A

bind to Factor VIII in serum and stabilizes it

25
Vitamin K deficiency
lack of vitamin K
26
What factors does thrombin activate?
V, VII, VIII, XI
27
what causes feedback amplification?
thrombin
28
Describe the feedback inhibition of clotting
thrombin binds thrombomodulin and activates protein C which binds protein S (and Ca). C-S complex cleaves V, and VIII
29
serpin
serine protease inhibitors | regulate cascade by inhibiting coagulation or fibrinolysis
30
antithrombin III
irreversibly inactivates thrombin | binds heparin then thrombin, heparin dissociates
31
heparin
enhances antithrombin IIIs affinity for thrombin and is used as an anticoagulant
32
fibrinolysis
dissolving of the clot
33
plasminogen
plasma protein that is incorporated into clot during coagulation
34
what causes proteolysis of plasminogen (creates plasmin)?
tissue plasminogen activator (tPA) | urokinase (U-PA)
35
plasmin
protease that cleaves fibrin and clotting factors
36
where is tPA synthesized?
vascular endothelial cells
37
where is urokinase produced?
most tissues
38
what increase the synthesis and release of tPA and UPA?
stress | hypoxia
39
What two things can you treat a MI or stroke?
tPA | streptokinase
40
hemostatic balance
the balance of coagulation and fibrinolysis
41
hypercoagulation
stroke, MI, thrombosis
42
hypocoagulation (too much fibrinolysis)
trauma, major surgery, hemophilia
43
Deficiency in Factor VIII
hypocoagulation
44
advanced liver disease
hypocoagulation
45
deficiency in protein C
hypercoagulation
46
vitamin K deficiency
hypocoagulation
47
mutation in factor V at protein C cleavage site
hypercoagulation | Factor V Leiden
48
platelet deficiency
hypocoagulation | thrombocytopenia
49
Deficiency in Factor IX
hypocoagulation | hemophilia B
50
What are the 5 types of common coagulation disorders?
1- diffuse intravascular coagulation (DIC) 2- thrombocytopenias 3- clotting factor deficiencies 4- drug induced hypocoagulation 5- effects of surgery on coagulation (hypercoagulative effects)
51
What are the three drugs that cause hypocoagulation?
asprin and antiplatelet warfarin heparin

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